Author Archives: Rita Asamoah Osei

wound care

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During simulated placement, I had the opportunity to join the wound care session. Most area of wound care was covered in this session which included gaining knowledge of the different types of wounds, factors affecting wound healing, wound assessment, wound cleaning and wound dressing. There was a brief discussion about the skin, its layers and the function of each layer. I understand that the outer layer of the skin known as epidermis acts as a protective barrier and controls water loss to prevent dehydration. The middle layer known as the dermis is made up of connective tissues which is a semi-fluid substances consisting of collagen and elastic fibres. The subcutaneous tissues also known as the hypodermis is the lower layer of the skin and it functions to protect the body’s temperature.

I understand that during skin assessment some factors must be considered which include areas of dry and scaly skin, skin perfusion, size, location and duration of the wound, signs and symptoms of skin rashes, oedema and temperature. I gained knowledge about the four stages of wound healing which included homeostasis, inflammation, proliferation and maturation. I gained knowledge about the type of wounds which includes and not limited to surgical wounds, pressure ulcers, laceration, burns, traumatic wound leg ulcer and diabetic ulcer. TIMES is the acronym used during wound assessment where T stands for Tissue, I stands for Infection, M is for Moisture and E for Epidermal advancement. During wound assessment it is important to identify if there is dead or unhealthy tissue present and if wound is infected. Wounds will be painful , swollen or smelly if infected. It is important to know if wound is wet and if so, why? Consider surrounding skin to determine if there are any barriers to the wound healing or if edges are healthy.

Many factors can affect the process of wound healing which may include drugs, infection, obesity, nutritional status, or dressing. I gained in-depth knowledge in wound dressing and the types of dressing available. I understand that during wound dressing one must always think about comfort and minimise stress and trauma by covering the wound. Always provide a non-adherent primary contact layer as a base for other secondary dressings or bandages. Appropriate wound dressing is relevant to the NMC code as it directly relates to several key principles that underpin safe, effective and professional nursing practice. NMC code emphasises on prioritising people by putting their care and safety first. Proper wound dressing ensures that patients receive the best possible care to promote healing, prevent infection, and manage pain. This demonstrates a commitment to high standards of patient care and prioritises their wellbeing. Acquiring wound care knowledge will benefit me in my nursing practice as I will be able to use the best available evidence to provide care. I will keep myself informed about the latest advances in wound care, understanding different types of wounds and select and utilise the most suitable and appropriate wound dressing materials and techniques. By adhering to the principles of wound care, I will be able to align my practice with the NMC code, thereby delivering high-quality, safe, and effective care.

Speech and language therapy

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During the simulated placement, I had the opportunity to join the IPL workshop where there were discussions on speech and language therapy which included communication, consent and mental capacity. There were discussions surrounding the impact of communication difficulties on engagement with healthcare professionals and the barriers to communication that impact healthcare professionals’ relationship building, gaining consent and mental capacity. The workshop involved adult nursing students, mental health students and physiotherapy students. There was role play scenarios which enabled all the different fields involved to learn from each other.

I gained knowledge about different communication disorders which impairs one’s ability to receive, process and comprehend verbal, non-verbal and graphic symbols. I understand these disorders can arise from factors including neurological and developmental issues. The session explored the importance of gaining consent which I understand is crucial in healthcare. Gaining consent ensures respect for an individual’s autonomy and their right to make informed decisions about their health. Healthcare professionals must ensure that individuals are fully informed about the potential risks, benefits and implications of a procedure or treatment to empower them to make knowledgeable decisions. .By gaining consent, a person’s right is protected by ensuring they have control over what happens to them and preventing privacy breach. I understand that communication barrier can impede the process of gaining consent, creating barriers that may affect a person’s understanding and ability to make informed decisions. People with communication difficulties may find it hard to comprehend information which can lead to misinterpretation or misunderstanding the risk or benefits of a procedure or treatment. This can make it difficult for them to indicate their consent or refusal.

The session further discussed Mental capacity act which I understand is a law that provides a framework for making decisions on behalf of people who lack the capacity to make decisions for themselves. I understand capacity is decision-specific and time-specific, meaning an individual can have the capacity to make some decisions but not others, and their capacity can change overtime. Factors that are considered when assessing a person’s capacity include their understanding, retention, how they are able to use information and how best they can communicate their decisions either verbally or non-verbally. Decisions made on behalf of an individual who lacks capacity must be made in their best interest considering their feelings, beliefs and values.

My understanding and skills related to communication difficulties, consent and mental capacity will significantly enhance my nursing practice. It will enhance my patient-centred care skills. By recognising and adapting to communication difficulties, I can ensure that patients understand their treatment options and care plans which will foster a supportive environment where patients feel heard and valued. It will help me tailor communication approach to each patients needs to improve cooperation which can lead to accurate assessment and better outcomes. My understanding of informed consent will ensure I obtain valid consent, which is crucial for ethical practice. This will protect patients’ rights and uphold my professional integrity. Being proficient in understanding mental capacity will help me make appropriate decisions about patient care, ensuring that those who are unable to make decisions for themselves receive the best support and protection.

Understanding communication difficulties and gaining consent is a fundamental aspect of the nursing and midwifery council (NMC, 2018). NMC code 1.1 requires nurses to prioritise people and by gaining consent, a healthcare professional is respecting an individual’s dignity and their right to make decisions about their care. The NMC code 1.2 emphasises about involving individuals about decisions concerning them. It is important to recognise and address communication difficulties to better involve patients in their care.